STORY BYEvery year, more than 600,000 women in the United States undergo a hysterectomy, a major surgery that involves removing the uterus and, sometimes, the ovaries and fallopian tubes. Approximately 20 percent f these hysterectomies are performed to alleviate the pain and bleeding caused by uterine fibroids, non-cancerous growths in the uterus.
Interventional radiologists at The University of Texas Medical School at Houston, however, say that treating uterine fibroids doesn't necessarily mean having a hysterectomy. Some patients with uterine fibroids may be candidates for a non-surgical procedure called Uterine Fibroid Embolization, or "UFE."
To perform UFE, an interventional radiologist inserts a catheter into a blood vessel from the groin, then advances the catheter to the uterine artery. Small, sand-like particles composed of a plastic compound are then injected into the artery, causing a blockage. Once these feeding arteries are blocked, the fibroid is starved of blood. Without blood, the fibroid shrinks, and the symptoms caused by the fibroid begin to resolve.
Artificially-created blockages
in the feeding artery "starve"
the fibroid.
Unlike a hysterectomy, which is performed under general anesthesia and usually requires a stay of several days in the hospital followed by weeks of recovery time, UFE is performed in a radiology suite without general anesthesia and typically requires only an overnight stay in the hospital. The procedure involves a single incision in the skin that usually measures less than one centimeter in length.
UFE is not an option for all patients; those with cancer, pelvic inflammations or infections, or those with kidney problems are generally not good candidates for UFE. And, while there have been documented cases of safe pregnancies and deliveries following UFE, doctors recommend that only women who no longer wish to become pregnant consider the procedure.
"For some patients, UFE is a good alternative to surgery. Unfortunately, these patients aren't always aware that UFE is a treatment option," says Lucho Rossman, M.D., an interventional radiologist with the medical school. "When it comes to patients making sound decisions about their care, knowledge is crucial. Patients must consider all the possibilities in order to make truly informed decisions."
Janet Holt knows this firsthand. Several years ago, after repeated trips to the doctor, her former gynecologist told her that she needed a hysterectomy to alleviate severe bleeding caused by a fibroid tumor. "He told me that in order to stop the bleeding, they would have to remove my uterus," Holt says. "He never suggested any alternatives. Since I couldn't deal with the bleeding anymore, I let him schedule me for a hysterectomy, even though I didn't want one and really couldn't give up six weeks of my life afterward to recuperate."
Lucho Rossman, M.D., an
interventional radiologist at
The University of Texas
Medical School at Houston,
holds one of the catheters he
uses to perform uterine fibroid
embolizations, an alternative to
hysterectomy for many women
suffering from uterine fibroids.
Photo By: Shannon Rasp
In June 2002, Holt and her husband arrived at the hospital for her surgery. She was prepared for the procedure, an IV was inserted, and an anesthesiologist arrived to sedate her. He looked at her blood test results and immediately halted the preparations. Holt, a diabetic, had spiked an extremely high sugar level, and doctors couldn't lower it. The anesthesiologist would not clear her for surgery. So, after all of the preparation, Holt and her husband were sent home.
A few weeks later, Holt's husband saw a brief news segment about UFE. He began researching it, determined to find out if his wife was a candidate and if there was someone in Houston who could perform the procedure. His persistence led him to UT, where doctors assessed Holt, determined she would benefit from the UFE, and performed the procedure in October 2002.
"I'm completely symptom-free now, and couldn't be happier," Holt says. "This procedure was a blessing. Once I learned about it, I wanted it, and nothing was going to stop me from having it." Holt had the UFE on a Thursday, was discharged from the hospital Friday, went grocery shopping on Saturday, and returned to work Monday.
"I want every woman suffering from uterine fibroids to know that a hysterectomy may not be your only option," Holt says. "Your doctor may not know about UFE, but it does exist, and in my opinion UFE is far preferable to a hysterectomy if it's determined you are a good candidate."
Rossman adds, "For some patients, it's very simple - they'd rather avoid surgery, if possible. If these patients are candidates for a curative yet non-surgical procedure and don't know about the procedure, then they should be made aware."
For more information about UFE, contact the UT Medical School at Houston's Department of Diagnostic and Interventional Imaging at 713-500-7700.
UPDATED: 1-18-2005
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Dr. Lucho Rossman is an interventional radiologist with the UT Medical School.
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Foods such as apples, berries, oranges, beans, broccoli, bran, multigrain breads and cereals should be added slowly into your diet, followed by an increase in fluid intake. Eventually you want to work up to 4 ½ cups of high fiber foods a day.
Otherwise, you might find yourself feeling more bloated, gassy or experiencing stomach cramps.So, add one high-fiber food at a time about a week apart. Increase your water intake (which includes unsweetened teas, diet sodas, juice) to eight glasses a day to help the fiber move through your system.
